9 | Nursing homework help

 You will collaborate with two of your classmates to share ideas and offer feedback and suggestions to one another in an informal setting. This collaboration within your group will assist you in further developing your Change Proposal to be submitted for feedback from your instructor next week. 

Don't use plagiarized sources. Get Your Custom Essay on
9 | Nursing homework help
Just from $13/Page
Order Essay

Peers submission attached below.. please provide feedback and suggestions individually!!

Peer 1:

Victoria Lyons posted 

IV. Implementation Plan

Assess the factors that are likely to affect the implementation of your recommended activities

Many stroke patients require rehabilitation after their hospitalization and many patients get readmitted from post-acute care facilities, educating these facilities could decrease the readmission rate however rehabilitation facilities are often short-staffed and may not have money for education amongst the staff


Identify evidence-based rationales to propose how you will address them, incorporating your identified change theory. Your plan should encompass the following with evidence to support your rationale:

Technological challenges

Stroke patients require adequate follow-up care with their health provider team, tele-health is a great way to provide these follow-up appointments however stroke patients may not be able to navigate computers to be able to do these appointments as they frequently have deficits.

Stroke health care providers would have to learn how to use tele-health and there may be push back to using it due to health care providers typically using hands on assessment skills, they may not find assessing patients this way adequate. Finding a group of health care providers that are willing to start treating patients this way is the first step.


Institutional structures

Changes in hospitals do not happen overnight. At my state run hospital it seems to take forever to get any changes made. Implementing education regarding how to reduce stroke readmissions would require research and then approval from many different committees to even be approved for implementation. Once approved then it has to be sent all to all hospital staff involved. Examples of committees that a hospital will have and that any changes would have to go through are finance, safety and quality, strategic planning, and audit and compliance committee (Price, 2018).

Strategies for building buy-in-among different stakeholders, including nursing

Doctors, nurse practitioners, physician assistants, physical therapists, social workers, and case managers will need to be on board with the change process. Historically nurses have a hard time with change.

Financial trends and anticipation of the availability of human resource and project funding

Implementing tele-health and training to decrease stroke readmission, mostly education and new ways to check that everything a patient needs, will cost money which the institution will have to be prepared to put into their budget. Institutions get penalized financially for readmissions so increasing efforts to decrease these would be a financial benefit (Kripalani, Theobald, Anctil, & Vasilevskis, 2015).

Hospital or governmental policy constraints

It may be tricky for patients that have strokes that are on Medicaid or Medicare and    working around their insurance policies. Within hospitals it takes time to get a policy

set into place.

Regulatory requirements

Some regulatory acts that would have to be taken into consideration would be The Health Information Technology for Economic and Clinical Health Act (HITECH) (Maryville University, 2020) and the Medicare Access and CHIP Reauthorization Act of 2015 (Maryville University, 2020). The MARCA works with a payment model for quality of care, reducing readmissions would help with reimbursements (Maryville University, 2020).

Patient diversity

Educating patients on ways to decrease their admission will have many different considerations. Reading levels, language spoken, family support, use of technology, what disability they have after their stroke. Understanding why groups of people tend to get readmitted over others is an important way to decrease admissions. Individuals less than 80 years of age had a less chance of being readmitted over individuals over 80, this was related to statin use (Poston, 2018).



Kripalani, S., Theobald, C., Anctil, B., & Vasilevskis, E. (2015). Reducing Hospital Readmission: Current Strategies and Future Directions. Annu Rev Med, 1-18.

Maryville University. (2020). 5 Important Regulations In United States Healthcare. Retrieved from Maryville University: https://online.maryville.edu/blog/5-important-regulations-in-united-states-healthcare/

Poston, K. (2018). Reducing readmissions in stroke patients. American Nurse Today, 9-15.

Price, N. (2018, August 24). Board Structure of a Healthcare Institution. Retrieved from Board Effect: https://www.boardeffect.com/blog/board-structure-healthcare-institution/

Peer 2:

Zachary Erickson posted 

Victoria and Lisa, 

   My apologies for late submission this week. I know it doesn’t leave you much time for feedback and I will try to be more prompt in the future. 

   My implementation plan is coming together but I look forward to your thoughts on what to add and what to clarify. Let me know what you think.


Change Proposal: Work-Related Bullying

Implementation Plan Utilizing Lippitt’s Phases of Change, (Mitchell, 2013)

Raising Awareness of The Need for Change

Create buy-in for the change process by appealing to direct and indirect victims of WRB. Build enthusiasm by drawing attention to commonalities and shared experiences.

Multimedia approach incorporating;

Visual printed media to spark collaboration and create a dialogue

Initial email surveys to gain baseline data and identify areas of greatest need

Opening anonymous reporting channels to increase communication and involvement

Overcome technological hurdles is essential during this phase. Identifying and utilizing existing resources within the organization starts by reaching out to internal research, quality management, and information technology departments to secure support and time commitments for the development of infrastructure changes that facilitate reporting and data collection. This ties into the next phase of change.

Building a Relationship with The System

Presentation of a completed Change Proposal to nursing leadership and members of administration.

Clearly stating the evidence-supported physical, psychological, and financial costs to patients, staff members, and the organization at large

Accurately estimating the time and resource commitment necessary for program development and ongoing success

Building buy-in on an administrative level

Reaching out to unit managers to identify their perception of WRB and its prevalence on their individual work environments

Involvement of employee health/occupational medicine staff as partners in the reduction of workplace stressors through larger behavioral changes.

Further promotion of the WRB reduction initiative among staff members and identification of staff champions passionate about these changes.

Defining the Problem

What does WRB look like?

Where is WRB occurring in this work environment?

What is the direct impact to staff members?

How does WRB impact our patients?

What are the long-term ramifications of allowing WRB to go unaddressed?

Are there policies in place that address WRB? If so, do they need to be modified?

Setting Goals and Action Planning

Time sensitive goals create milestones and improve evaluation of program success. Program phases will be rolled out quarterly, with the relationship building and collaborative planning happening in the first quarter after program approval, followed by the initial campaign to raise awareness in the second quarter, and full program implementation on select units slotted for six months after approval. Evaluation of successful change will occur quarterly thereafter to measure program effectiveness, make changes, and incorporate new work areas.

Action planning should be interdisciplinary and tailored to the needs of individual work environments. Buy-in and early adoption of the program is essential to the success of this phase.


The operational model will be relationship-based and involve several components

Psychodynamic education based on cognitive behavioral models

Cognitive rehearsal training, i.e. role-play, universal anti-bullying phrases, resilience training

Policy enforcement training: building awareness and support for new or changed policies

Coaching: using the established reporting system to identify WRB trends and address areas of highest incidence                                                               (Balevre, Balevre & Chesire, 2018)

Weekly program updates with core program supporters and monthly meetings with staff champions will identify areas of success and areas in need of reevaluation.


Change program success depends on acceptance and sustainability

This means consistent administrative support through the enforcement of zero-tolerance policies that directly address WRB events in a timely and supportive fashion.

Ongoing evaluation of staff awareness and involvement in initiative. Monthly review of staff feedback and yearly retraining as part of core safety measures.

Maintaining program flexibility and changing delivery of training and monitoring strategies to best suit each work environment.

Redefine the Role of the Change Agent

Once the change process is initiated, the change agent works to keep others on track with program support and involvement.

Coordinate the feedback review efforts and continue to recruit interested staff members to act as program champions.

Liaise with administration members and continue to “bridge the gap” between program results and the impact on staff and patients.

Share program successes both within the organization and with the community.



Balevre, S., Balevre, P., & Chesire, D. (2018). Nursing professional development anti-bullying project. Journal for Nurses in Professional Development, 34(5), 277-282. doi: 10.1097/nnd.0000000000000470

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37. doi: 10.7748/nm2013.

Order a unique copy of this paper
(550 words)

Approximate price: $22

Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our Guarantees

At 111papers.com, we value all our customers, and for that, always strive to ensure that we deliver the best top-quality content that we can. All the processes, from writing, formatting, editing, and submission is 100% original and detail-oriented. With us, you are, therefore, always guaranteed quality work by certified and experienced writing professionals. We take pride in the university homework help services that we provide our customers.

Money-Back Guarantee

As the best homework help service in the world, 111 Papers ensures that all customers are completely satisfied with the finished product before disbursing payment. You are not obligated to pay for the final product if you aren’t 100% satisfied with the paper. We also provide a money-back guarantee if you don’t feel that your paper was written to your satisfaction. This guarantee is totally transparent and follows all the terms and conditions set by the company.

Read more

Zero-Plagiarism Guarantee

All products that we deliver are guaranteed to be 100% original. We check for unoriginality on all orders delivered by our writers using the most advanced anti-plagiarism programs in the market. We, therefore, guarantee that all products that we submit to you are 100% original. We have a zero-tolerance policy for copied content. Thanks to our strict no plagiarized work rule, you can submit your homework to your professor without worrying.

Read more

Free-Revision Policy

TThis is one of the most cherished courtesy services that we provide to help ensure that our customers are completely satisfied with our finished products. Delivering the best final product to our customers takes multiple inputs. 111papers.com prides itself on delivering the best university homework help services in the writing industry. And, in part, our free revision policy is how we do it. What’s more, all our revisions are 100% free without any strings attached.

Read more

Privacy Policy

Client privacy is important to use. We know and understand just how important customers value their privacy and always want to safeguard their personal information. Thus, all the information that you share with us will always remain in safe custody. We will never disclose your personal information to any third party or sell your details to anyone. 111 Papers uses the most sophisticated, top-of-the-line security programs to ensure that our customers’ information is safe and secured.

Read more

Fair-Cooperation Guarantee

Placing your order with us means that you agree with the homework help service we provide. We, in turn, will endear to ensure that we do everything we can to deliver the most comprehensive finished product as per your requirements. We will also count on your cooperation to help us deliver on this mandate. Yes, we also need you to ensure that you have the highest-quality paper.

Read more

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
The price is based on these factors:
Academic level
Number of pages